Re: Cytotec , Prepidil,Cervidil and my mistake
From: Anna Meenan, MD (annam@uic.edu)
Sat Sep 18 09:26:37 2004
In the US, Cervidil is dinoprostone 10 mg. It comes in the form of a
small wafer wrapped in a little gauze pouch with a long tail on it. It
is used for cervical ripening at term, placed in posterior fornix for 12
hours, or until active labor starts. It is much more expensive than
cytotec, so it is not used routinely a lot of places, but it's nice if
there is any concern about how the baby will tolerate labor, because if
you get hyperstimulation or fetal distress, you pull it out and it's
gone.
--
Anna Meenan, MD
At Sat, 18 Sep 2004, emilio porro wrote:
>
>I am sorry for the big mistake I have done in the e-mail (I was tired for too work)
>Here in Italy:
>Cervidil(Serono)gemeprost 1 mg one vaginal tablet 38,61 euro each is used only for cervical ripening in missed abortion or voluntary interruption of pregnancy in first trimester.
>It is never used at the end of pregnancy for cervical ripening.
>Prepidil (Pharmacia):vaginal gel
>0,5 mg endocervical each 49,98 euro
>2mg intravaginal each 67,58 euro
>Is used at the end of pregnancy for cervical ripening and induction of labor.
>Cytotec 200 (Pharmacia) 50 oral tablets of 200mcg 15,47 euro
>There is in Italy few experience for induction of labor at the end of pregnancy or for cervical dilatation when missed abortion (ex.bligthed ovum)
>I am correct that Cervidil(Gemeprost) in USA is used for cervical ripening at the end of pregnancy as posted by several collegues?
>Yours faithfully
>Emilio Porro MD ObGyn
>Como-Italy
>http://www.sanbonaventura.com
>
>You wrote:
>>From: Steve & Eryl Raymond <eryl@intekom.co.za>
>>Reply-To: ob-gyn-l@obgyn.net
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>Subject: Re: Cytotec vs. Prepidil
>>Date: Thu, 16 Sep 2004 22:41:37 -0500
>>
>>Cytotec is the only thing we use for ripening in first and second
>>trimesters - 400 to 600 mcg inserted PV the night before a TOP. By
>>definition you don't have to dilate a complete, incomplete, or
>>inevitable abortion - the cervix is already dilated. For missed
>>abortion it may sometimes be necessary to use a ripening agent and
>>then we use Cytotec. Prepidil is ineffective for first trimester -
>>it is Prostaglandin E2, in a dose which is applicable only to the
>>term pregnancy. So your "Chief Department" is right and you will
>>save a lot of money given that the cost of Prepidil is at least 100
>>times that of Cytotec. You have been wasting a lot of Euros.
>>Steve Raymond
>>
>>emilio porro wrote:
>>
>>>Recently, our Chief Department suggested for economical reasons to
>>>stop the use of Prepidil for cervical ripening before evacuation
>>>by currettage for complete,incomplete or internal spontaneous
>>>abortion .
>>>
>>> We use it to avoid cervical dilatation with hegar with risk of
>>>uterine perforation,cervical rupture with also the risk of
>>>medico-legal litigation
>>>
>>>How is Your experience in the use of misoprostol in this
>>>situations?.
>>>Thank You in advance
>>>Emilio Porro M.D.
>>
|
|
